Can someone please tell me if this is fat or loose skin? (photo)

70% fat, 30%skin laxity. I would recommend either lipo or Coolsculpting to reduce the fat. Your skin might tighten enough that it doesn't jiggle. Good luck.

You have both loose skin and fat.  The  relapse and residual skin laxity is most likely a result of your signficant weight loss.  Weight loss patients can have relapse of their skin laxity after a procedure as a result of the extreme weight change and changes in collagen.  Repeat operation with removal of additional tissue is sometimes necessary in severe cases. It is a consequence of your biology and physical findings and not the procedure.  Whether you pursue an additional procedure depends on how much correction you desire.  All the best! 

I think it is a combination of both, given your weight loss but only an exam can elucidate this. I would not anticipate that your skin will contract sufficiently with lipo alone and this is obviously a major consideration given your profession.